title: Pyogenic liver abscess as a warning sign for primary liver cancer: a nationwide population-based study.
abstract: BACKGROUND
  There have been no large-scale population-based studies to estimate the subsequent risk of primary liver cancer (PLC) among patients with pyogenic liver abscess (PLA). This study aimed to provide relevant data.
  
  
  METHODS
  The Taiwan Longitudinal Health Insurance Database for the years 2000 and 2005 was used. The PLA group were adult inpatients who were newly diagnosed with PLA from 2000 to 2008. The control group was randomly selected and matched with the PLA group in terms of age, sex, and date in which medical treatment was sought other than for PLA.
  
  
  RESULTS
  There were 1,987 patients each in the PLA and control groups. In total, 56 had PLC, 48 (2.4%, 601.5 per 100,000 person-years) from the PLA group, and 8 from the control group. After adjusting for potential covariates, the hazard ratio of PLC for the PLA group was 3.4 times that of the control group (95% confidence interval = 1.6-7.3, p <0.001). The PLC risk for the PLA group was significantly higher within the first year after PLA diagnosis (hazard ratio: 35.4) as compared with the control group and became insignificant (hazard ratio: 2.0, 95% confidence interval = 0.8-4.9) more than one year after PLA diagnosis.
  
  
  CONCLUSIONS
  Patients with PLA have a higher rate of PLC than matched controls, especially within the first year after the diagnosis of PLA, suggesting PLA is a warning sign for PLC.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan E-mail : lichu@mail.cgu.edu.tw.
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Huang
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Lin
authors.forename: Meng-Jiun
authors.initials: MJ
authors.lastname: Chiou
authors.forename: Tsai-Sheng
authors.initials: TS
authors.lastname: Yang
authors.forename: John Wen-Cheng
authors.initials: JW
authors.lastname: Chang
authors.forename: Kuang-Hui
authors.initials: KH
authors.lastname: Yu
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Kuo
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D046290:Liver Abscess, Pyogenic / Q000150:complications*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D011379:Prognosis; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult